To kick off this year’s PERS Summit, AvantGuard hosted a tour of its recently remodeled Ogden, Utah, headquarters. Small groups of about eight people each were shown each department. Veronica Smith, account executive with AvantGuard, led my tour group.

The remodel was extensive, and involved moving entire departments across the building’s three floors.

Certain aspects of the remodeled building stand out. All employees have similar workspaces in a very open floor plan; no one has a separate office. The updated building also includes a new lounge for employees. Additionally, every workstation is outfit with a convertible desk for sitting and standing.

Rich Watts, VP of information technology, gave and overview of the IT department. Watts also detailed the levels of redundancy, between the company's Ogden, Utah, and Rexburg, Idaho, and locations, for alarm communications.

Madison Barlow, company director of training and quality assurance, outlined the training process for new employees, including a written exam to in-call center training. This process is followed by quality assurance audits. The company also has coaches, she pointed out, which work with the operators and hear feedback and ideas.

Spencer Dean, operations manager working in AvantGuard’s Idaho facility, met with the tour to talk about culture and finding the right people. Dean pointed to a company saying to illustrate AvantGuard’s culture, that AvantGuard cares F.I.R.S.T., meaning the company cares, it is Fun, it is Innovative, it values Relationships, focuses on Service, and builds Trust. He also highlighted that both of AvantGuard’s facilities are close to universities, allowing the company to bring in college students with new ideas.

Suzie Nye, AvantGuard’s VP of operations, discussed the company’s monitoring center. A big difference following the remodel was bringing the monitoring from the first floor to the third floor. When the monitoring center was on the ground level, windows needed to be blocked as a requirement for UL certification. Now, the monitoring center is just about surrounded by windows that can let in natural light. Troy Iverson, AvantGuard’s vice president, commented on an increase in productivity after the move.

Rich Slater, the company’s VP of human resources, talked about his team’s approach within HR, as focusing on the employees as well as the company as a whole.

The first day ended with a networking reception at The Chateaux Deer Valley, where the conference is being held.

Wednesday, Sept. 27

Justin Bailey, AvantGuard president and COO, presented Wednesday’s first session on “The Future of PERS Monitoring.”

Bailey first started by taking a look back at the predictions he made about the PERS industry and where it was headed in 2013.

He warned of the demise of the landline. In the last two years, he said, there are more homes with only cellphones than those with landlines.

Next he took a look at VoIP and how that’s progressed. AvantGuard has seen massive growth in non-traditional communication, according to Bailey.

MPERS has also grown greatly since 2013. In 2013, AvantGuard’s medical monitoring was 3 percent mPERS, it grew to be 36 percent in 2015 and now—the majority—55.3 percent in 2017.

Another prediction Bailey had in 2013 was toward the advancement and use of location services, and noted significant growth in that area. While there is cell ID and GPS, "What we're seeing now in the industry is the use of Wi-Fi location," he said.

Additionally, at this year’s PERS Summit he highlighted IPS—or indoor positioning system—technologies, and predicted more of those in the future.

Not all of his predictions came true; Bailey also discussed some that missed. In 2013, he predicted a large PERS and Telehealth convergence. While that hasn’t happened, Bailey expects that it will come in the future.

Similarly, the obsolescence of equipment refurbishment was another 2013 prediction from Bailey that wasn't seen in the last four years, but he still predicts it's coming up down the road.

Bailey then showed a short video to illustrate AvantGuard’s work with PERS, a true story of when an AvantGuard used the proper procedures after receiving a PERS alert. The operator, after speaking with the user and dispatching paramedics, contacted a family member who informed him of certain doctors the PERS user should be taken to. By then contacting the paramedics, the user was able to get the help she needed.

AvantGuard refers to its operators as “heroes” and following the video, Bailey asked all of AvantGuards heroes in the room to stand up and be recognized.

Times are changing, according to Bailey, with increasing Internet and social media usage as well as the number of smart phones and cell phones. One demographic that he highlighted was those 50 to 64 years old, 97 percent of who have a smartphone or cell phone.

Bailey looked at the process of the call list on an alarm, which hasn’t changed much in a while; calling a home number for one contact, then calling their cell, then moving on to the next contact. He shared that when a landline rings now, a person may not answer, thinking if it’s important they’ll receive a call on their cell. Likewise, some people are not inclined to answer a call on their cell phone from a number they don't know. The process of reaching someone can take time.

This process could be changed if AvantGuard’s sent a text message to several people on a call list. The message would include a link to a browser-based chatroom, where members of the call list can discuss the alarm. Bailey called the model "Interactive Parallel Monitoring," and said it could result in improved notification and response times, meaningful caregiver involvement, increased subscriber retention.

Enhanced caregiver engagement is the future of PERS, according to Bailey.

Technological advancements can disrupt and industry. Bailey gave the example of the taxi industry, disrupted by Uber’s capabilities with a smart phone. "I want to challenge each of us to not be the taxi industry," Bailey said.

The day’s second session looked at PERS cases in court, and what business can do before, during and after potential litigations. Philip Kujawa, attorney with Hinshaw & Culbertson LLP, opened by saying that this presentation is not legal advice.

Specifically, Kujawa looked at what a PERS company could do to prepare for or prevent a lawsuit, such as a wrongful death suit following the death of a PERS user.

The PERS user is not a medical alarm company’s enemy, Kujawa said, and the people who get PERS to help a loved one are not either, typically. The potential problem is with people who buy a PERS for a family member out of guilt. Kujawa said that he finds plaintiffs in wrongful death cases against PERS companies don’t have a great relationship with the deceased.

"Try to evaluate who it is that's purchasing the product from you," he said. "Put high caution on those customers." If a person is paying for the PERS unit but doesn't want to be on the call list, that can be a sign of potential trouble.

Litigation in this arena is new, according to Kujawa. Unfortunately, alarm companies don't have the greatest reputation, which can make them a target, he said. Additionally, some states are more litigious than others, he said, pointing to Louisiana, Missouri, Illinois, California, and Florida as the five worst states.

"Unfortunately, you have to think about being defensive," Kujawa said, and the best defense is a good offense. In order to offensively protect a company, attendees should do a good job with their businesses, he said, adding that attending an industry conference is a good sign. Company’s that want to be defensive can develop, adopt and implement best practices in all facets of the business.

Contracts are critical, not having one is very helpful to the plaintiff’s lawyer, Kujawa said. "I want the person wearing the pendant to sign that if they can," he said; family members bringing a suit would not have better rights than the deceased. After the user themselves, the next best thing would be to have the person who is most responsible and involved in the user's life as the signatory. "What I don't want is somebody completely remote to the end user signing the contract; [such as] the hospital, the nursing home."

In preparation before a suit, those on the frontline should be aware of when they receive complaints after an event—such as a user’s death—and get the facts, do an internal investigation. Kujawa also encouraged attendees to save any media coverage related to the event, as it might be helpful. He stressed that companies should be careful regarding requests for information. Freely sharing information that the company isn’t required to—like an alarm history—may appear helpful but can create more problems in a lawsuit, he said.

Laurie Orlov, founder of Aging in Place Technology Watch, presented the last session of the day, “Key Technology Trends for the Aging Beyond 2017.”

Orlov began by pointing out four key technologies needed in the aging in place market: communications and engagement, safe and security, learning and contribution, and health and wellness. From there, Orlov examined the ways these technologies fit around aspects of aging in place.

She started with home care, which is a space that sees a lot of turnover—at least 64 percent, according to Orlov. Potential reasons for this are that the work is labor intensive compared with other low wage occupations. Home care is a space that needs partners, devices and services, she said.

One technology that Orlov highlighted was voice interactions. This is the opportunity for virtual assistants, she said. For example, a senior could repeat questions with a virtual assistant, and the response would be the same, not annoyed or frustrated.

Currently, there are 9 million devices like this in homes, Orlov said, and by 2018, 30 percent of interactions with technology will be through conversations. Examples of this category would be Amazon’s Echo, Google Home, and Siri with Apple.

Orlov also addressed risks and concerns in the voice market, such as the cost of broadband, language support, and difficulties implementing the system through an app.

Another technology Orlov examined was wearables. Wearables are relevant because older demographics have pets and have to walk their dog; one third of the 65+ population has a dog, she said. While some wearables appeal to a users interest in fitness, that will give way to their interest in safety, said Orlov. She listed Phillips wearable, Freeus belle+, Unaliwear, FallSafetyApp and Kytera among examples for wearable technologies.

Wearables have changed, Orlov noted, becoming more mobile, accurate in terms of location services, and can be voice activated. One of the problems with safety wearables is that people forget to wear them, she said.

Virtual reality technologies also have potential among seniors because it can be used to show them different areas, outside of their facility, Orlov noted.

Thursday, Sept. 28

Jason Hewlett, the speaker giving the day’s first keynote presentation, gave lively impressions of various singers, including Michael Jackson, Diana Ross and Stevie Wonder. He pointed out how recognizable he was by simply copying one or two signature pieces of their stage presence.

Performers need to meet expectations by doing what their known for—their signature; MC Hammer had “Cant Touch This,” Billy Joel had “Piano Man,” Michael Jackson had his moonwalk. These are expectations—promises that each performer needs to fulfill when they take the stage, according to Hewlett.

"Have you thought recently about the unspoken promises inside of you?" Hewlett asked at the beginning of the session. "Each of us are performers in our line of work,” he said later.

Hewlett went on to discuss how, as performers, people have promises they need to fulfill in various aspects of their life, such as with customers or an audience, at work, at home and for themselves.

When it comes to delivering on the promise to a person’s audience, they need to consider whether the reality of their offering meets “the commercial”—their promise. "We just want to exceed expectations," he said.

People can look at work differently, as a family, Hewlett said. Additionally, everyone has a part that they play, and relying on others specialties can be a good thing.

Hewlett asked attendees whether they are consistent on and off the stage as performers. While work requires energy, so does home life, according to Hewlett; at the end of the day, he still needs energy to play with his kids.

He asked attendees to think about promises they have for themselves. These are promises that people break a lot, he noted.

He asked attendees to write down what they think they’re good at, pointing out that its more difficult than finding personal faults. A core theme of his presentation is that people need to recognize their gifts and share them.

Eric Allen, managing attorney with Allen, Mitchell & Allen based in Salt Lake City, presented the fourth session of this years PERS Summit, “New regulations for Texting and Automated Calls.”

Allen started by saying that he wouldn’t be focusing on state laws, but instead, talking more about federal.

Allen explored why this matter is important. FTC fines are now over $40,654 per individual violation, he said. TCPA—the Telephone Consumer Protection Act— plaintiffs can sue alone or in a class action for up to $1,500 per call. There are over 130,000 telephone numbers identified as being owned by individuals who sue telemarketers, and career plaintiffs or "serial litigators" on the rise.

While that seems daunting, some basic principles can offer hope, Allen said. "One, don't auto dial or auto text cell phones without consent," he said. "For anything other than an emergency call, you need some level of consent to text."

Don't send recorded messages without consent and be able to prove you had consent, he said—"have documentation."

One point that Allen highlighted a few times—something particularly relevant for the PERS industry—is that emergency calls are a big exception, though, companies should be sure not to include and marketing or upselling during that call. Allen also advised honoring opt-outs here as a best practice.

Allen covered new technologies in telemarketing, such as ringless—where a voicemail can be left without a calling seeming to go through—and avatar—where a person, regardless of their natural speaking voice, can use small recordings of someone else to sound more natural.

Henry Edmonds, president of The Edmonds Group, and Hugh Van der Veer, attorney at Buchanan Ingrersoll & Rooney, looked at “Best Practices for Buying and Selling a PERS Business,” by each taking a different side; Edmonds presented the seller’s perspective and Van der Veer presented the buyer’s perspective.

Edmonds opened the session with the seller’s perspective. Companies should be able to outline their strategy as well clearly articulate their strategy and tell the story of their business, he said. They should also be organized, and have good financial and operational reporting, he said.

Businesses looking to sell should consider their monitoring and make sure that customers could be moved to a different central station of monitoring service, Edmonds pointed out.

State and local taxes are an emerging issue, according to Edmonds, and companies that aren’t paying tax in every state where they have customers are going to encounter problems.

Van Der Veer added: “Be proactive, because the buyer is not going to let your problem become the buyer's.” Additionally, companies that approach the state before it becomes and issue may be in a better position in working to resolve an issue.

Edmonds ended his portion of the presentation by covering relevant metrics—such as creation cost and attrition rate—as well as other value drivers—such as the company’s reputation and the size of the transaction.

Van der Veer began by looking at some of the traits that would make up the idea buyer: a company already in the PERS space, well financed, one that is opportunistic but patient.

While Edmonds discussed where a seller’s reputation can come in, Van der Veer advised looking at that buyer’s reputation. Selling owners likely want to protect their employees and their customers.

Van der Veer outlined some key initial steps, including NDAs for the buyer and the seller, conducting due diligence and gaining exclusivity from the seller.

Common problems that can come up are legacy problems, or lacking critical third party consent, according to Van der Veer. There are also common solutions: sharing some risk, or the fact that the seller and buyer have come too far to walk away.

Ahead of both the 2015 and the 2017 PERS Summit, attendees were given a survey about their experiences in the PERS industry. John Brady, owner of TRG associates, shared the results of this year’s survey and how some of the responses differ from 2015’s survey results.

Included here are a few of the survey questions and some of their findings.

One question asked attendees for the number of subscribers they currently service, with answers ranging from less than 100 to more than 10,000. Some notable differences: the 5,000 to 10,000 category jumped from 7 percent in 2015 to 13.79 percent in 2017. The category of less than 100 accounts, was 21 percent of respondents in 2015 and now 17.24 percent in 2017.

Attendees were also asked about the number of customers expect to add in 2017? The average number of subscribers was 4579, with revenue ranging from $20,000 to $90,000.

What is the cost to create an account? Figures given by respondents dropped more than 100 dollars on average between 2015 and 2017.

Aron Ralston, author of Between a Rock and a Hard Place and subject of the movie 127 Hours, delivered the 2017 PERS Summit’s last session and second keynote.

Ralston was hiking in southern Utah when he came to a canyon where boulders were lodged. He described the experience of watching a boulder come lose above him, ricochet between the canyon walls on the right and left side of him, and trap his right arm from his fingertips to his wrist. "And that's where I reach for the pendant I always wear around my neck," he joked.

Ralston introduced himself as the guy that cut his arm off, but said he’d tell the story of being the guy who cut his arm off while smiling.

Metaphorically, everyone faces boulders in their lives, according to Ralston. "Whatever your boulders are, we get to make choices,” he said. Later in the session, he pointed out that he had made some big choices that impacted him: going alone and not telling anyone where he was headed.

Ralston was trapped under the boulder for more than five days, attempting various means of freeing himself—using ropes to move the boulder, chipping away at the area around his arm—before using a pocket knife to amputate his arm. “I felt every bit of it, and yet I was still smiling," said Ralston.

"Boulders, obstacles—they can also be our stepping stones," Ralston said. While the experience was extreme, it brought him clarity of what was important to him: his family.

"What we are capable of is a lot more than what we believe we’re capable of. ... We're only able to find that out because of the boulders," Ralston said.